What is our government on?

Submitted by admin on Thu, 2010-04-01 22:19

Jon Manning deals with the ABCs of Drugs policy

In October 2009, Professor David Nutt
of Imperial College London, chairman of the Advisory Council on the
Misuse of Drugs (ACMD), was sacked by home secretary Alan Johnson.
Professor Nutt had long been outspoken in his criticism of the
government's approach to drugs, famously criticising the decision to
re-classify cannabis back to class B from class C, against the ACMD's
advice. Nutt was sacked ostensibly because he had caused “confusion
between scientific advice and policy”. Controversy ensued, with
many in the scientific community pointing out that the comments were
made in professional arenas, separate from the Professor's advisory
role. The situation raises questions about the influence of
scientific advice on government drug policy. How exactly does
the government make decisions regarding drug safety and
classification in the UK? To what extent is scientific advice heeded?

The UK's current 'ABC' drug
classification system is based on the Misuse of Drugs Act (1971) ,
which also established the ACMD. The act was intended to “make it
possible to control particular drugs according to their comparative
harmfulness either to individuals or to society at large when they
were misused”. Accordingly, the penalties for those caught using
class A drugs are more severe than for class C. Despite this, the
only rationale for classification was that it was “the order in
which we think they should be classified of harmfulness and danger”,
and supporting evidence has never been provided. In fact, the
implicit justification for classification itself, that higher
penalties act as a greater deterrent, leading to less damage to
individuals and society, is itself unproven.

Given the arbitrary nature of the
initial classification, has subsequent scientific input been employed
to improve the system? The degree to which the government heeded the
ACMD's advice is highlighted in a 2006 report by the Commons' Science
and Technology Committee (Drug Classification: Making a Hash of
it?). Firstly, the much debated cannabis. Following years of
recommendations by the ACMD, the government decided in 2004 to
downgrade cannabis to class C, based on comparisons with the
generally more harmful drugs in class B (e.g. amphetamines). The
change resulted in reported savings of 199,000 police hours in the
following year. Meanwhile, continuing research had suggested links
between schizophrenia and perceived increases in the potency of some
cannabis products. The ACMD was consulted again in 2005 but concluded
that “the consumption of cannabis is neither a necessary, nor a
sufficient, cause for the development of schizophrenia”. It was
against this backdrop that a decision was made in 2008 to move
cannabis back to its present class B position; the then home
secretary Jaqui Smith said she was 'playing it safe'. In a less
publicised action, fresh 'magic mushrooms' were placed in the class A
category in 2005, alongside their dried and prepared counterparts.
The government did not consult the ACMD in this clarification,
leaving a relatively innocuous fungus, responsible for a single death
between 1993 and 2000, in the same class as heroin, which was
responsible for 5,737. Similarly, no consultation was made prior to
assigning ecstasy to class A in 1977, where it has remained ever
since, despite its death toll being less than 3% that of heroin in
2004.

What about the ABC system itself: are
there better systems available? There are certainly more rational
approaches. The US classifies drugs based on five 'schedules' related
to potential for abuse and known medical uses, supervised by the Drug
Enforcement Agency. The Netherlands has a simple two-part system
based solely on the potential for damage to individuals and society;
schedule I contains heroin, schedule II, cannabis. Professor Nutt,
along with his colleagues, proposed a scale himself in The Lancet
in 2007 that ranks substances by physical harm, dependence, and
damage to society. Of 20 drugs, heroin is public enemy number 1,
alcohol comes in at 5, with ecstasy coming close to the bottom of the
pile at 18. A ranking such as this, tightly associated with potential
damage, is a much more rational way to apportion the finite resources
available for controlling drug use.

Inevitably government policy is heavily
influenced by public opinion, leading to actions designed to win
votes more than solve problems. When such actions fly in the face of
reason, attention and resources are diverted away from the true
problems, with the result that we all lose out. Professor Nutt will
continue to provide a focus for this debate through his new
Independent Scientific Committee on Drugs. In January 2010 his less
strident successor, retired Oxford Professor Les Iversen took up his
post as chair of the ACMD. The knowledge and experience of these two
men could be invaluable to government - provided someone is
listening.